Question 1

Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged.To improve quality of care,a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented.This road map is referred to using what term?

Accepted Answer

The term "critical pathway" refers to a tool used in healthcare to guide evidence-based healthcare by standardizing the care process for specific diseases or procedures. It helps in improving the quality of care by ensuring that all necessary steps in the treatment process are followed, which is particularly useful for managing complex conditions like heart failure.

Question 2

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures.The focus of this team is primarily on which Institute of Medicine (IOM)competency?

Accepted Answer

The development of algorithms and checklists to standardize procedures directly addresses the IOM competency of Safety, as it aims to reduce errors and enhance the safety of patient care by ensuring consistency in how procedures are performed.

Question 3

The surgical team arrives in the operating room and one-member states,"Everyone stop.Let's identify the patient and operative site.Now does anyone have any questions or concerns?" This process is referred to by what term?

Accepted Answer

The process described is referred to as a "Time-out." It is a safety protocol used in healthcare settings, particularly before surgical procedures, to ensure that the surgical team correctly identifies the patient, the procedure, and the operative site, and addresses any last-minute questions or concerns. This practice helps prevent medical errors.

Question 4

A patient is ordered a low-protein,low-calorie diet but the patient's family brings fish,lentils,and unleavened bread for a meal to observe a cultural practice.The nurse works with the dietitian to adjust the next few meals to accommodate for this variance.What term should be used to identify this situation?

Accepted Answer

This situation is an example of patient-centered care, where healthcare providers adjust their care plan to accommodate the patient's cultural practices and preferences, ensuring that the patient's needs and values guide all clinical decisions.

Question 5

A nurse is assisting with the delivery of twins.The first infant is placed on the scale to be weighed.The physician requests an instrument stat.The nurse turns to hand the instrument to the physician,and the infant falls off the scale.When evaluating the incident,the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known,and the location of the scale so far from the delivery field.These nurses are engaged in what process?

Accepted Answer

Root cause analysis is a method used to identify the underlying reasons why an incident occurred. In this scenario, the nurses are examining the factors that contributed to the infant falling off the scale, which is a key aspect of root cause analysis.

Question 6

A nurse is asked to "float" to a telemetry floor and is to place a patient on telemetry monitor.The nurse is unfamiliar with placement of EKG leads and would consult which type of chart to learn the correct placement?

Accepted Answer

The answer of A nurse is asked to "float" to...

Question 7

A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to remove the dressing.The nurse accidentally cuts the sutures holding the incision,and evisceration occurs.In quality improvement,this incident is best identified using what term?

Accepted Answer

A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm. Evisceration after accidentally cutting sutures during dressing change is a serious and unexpected occurrence, fitting the criteria for a sentinel event.

Question 8

Regardless of the term used to describe high-quality health care,what is the primary focus of quality?

Accepted Answer

The primary focus of quality in healthcare is meeting consumer needs and wants, as it ensures that the care provided is patient-centered, addressing the specific health requirements and preferences of individuals.

Question 9

The number of IV site infections has more than doubled on a nursing unit.The staff determine common causes include the site is cleaned using inconsistent methods,dressing frequently becomes wet when patient showers,IV tubing is not changed every 48 hours per protocol,and inadequate hand washing of RN prior to insertion.A bar graph demonstrates the frequency in descending order,with 80% of infections being attributed to inadequate hand washing.The quality tool used is referred to as what?

Accepted Answer

The quality tool described is a Pareto chart, which is used to identify and prioritize problems or causes of a problem to work on correcting by showing their frequency in descending order. In this scenario, the bar graph showing the frequency of causes for IV site infections in descending order, with a specific focus on the most significant cause (inadequate hand washing), is characteristic of a Pareto chart.

Question 10

What nonprofit organization distributes knowledge related to health care for the purpose of improving health to governmental agencies,the public,business,and health care professionals?

Accepted Answer

The Institute of Medicine (IOM), now known as the National Academy of Medicine (NAM), is known for distributing knowledge related to health care with the aim of improving health outcomes for various stakeholders including governmental agencies, the public, businesses, and health care professionals.

Question 11

An organization's emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety.This type of diagram is referred to using what term?

Accepted Answer

The correct term for a diagram that details how each department will assist individuals in reaching safety during an emergency, such as a terrorist attack, is a Deployment Chart. This type of chart is specifically designed to show the roles and responsibilities across different departments or teams in a process, making it ideal for planning disaster evacuation procedures.

Question 12

Institute for Healthcare Improvement (IHI)proposed a process for quality improvement with steps known as "PDCA." What statement should be made when explaining the steps to a group of nurses interested in improving the process of medication reconciliation for heart failure patients with high rates of recidivism?

Accepted Answer

The answer of Institute for Healthcare Improvement (IHI)proposed a process...

Question 13

A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process.A step-by-step reference that shows how to complete the process is referred to by what term?

Accepted Answer

A top-down flowchart is a step-by-step guide that helps in understanding and executing a process, such as administering medication.

Question 14

The staff on a nursing unit notes that patient satisfaction varies from month to month.They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring.The staff uses which type of graph to present this information?

Accepted Answer

A time plot is used to display data points at successive time intervals, making it ideal for tracking changes, trends, or patterns over time, such as monthly patient satisfaction levels.

Question 15

A group of nurses are presenting the importance of high-quality care during a system-wide meeting of medical-surgical nurses.They point out a finding of the Quality Chasm that supports what?

Accepted Answer

The Quality Chasm report by the Institute of Medicine highlights the significant impact of medication-related errors on the U.S. health care system, including their financial burden. This report emphasizes the need for improving the quality and safety of health care.

Question 16

Nurses,physicians,and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks.Each member contributes based on his or her area of expertise but also recognize other members' strengths.Which of the QSEN competencies are being demonstrated?

Accepted Answer

This scenario exemplifies the QSEN competency of "Teamwork and Collaboration," as it involves various healthcare professionals (nurses, physicians, social workers) working together, each contributing their expertise towards a common goal of coordinating care and discharge for a homeless patient. This collaborative approach is key to effective healthcare delivery.

Question 17

According to the Quality Chasm report what statement is true?

Accepted Answer

The Quality Chasm report emphasizes the need for health care providers to be proactive rather than reactive to patient needs, focusing on preventive care and anticipating patient needs before they become acute problems.

Question 18

During the night,a patient fell in the bathroom and sustained a hip injury.The patient was very upset because of being unable to attend a granddaughter's wedding in 2 days.The team looked at the process and determined that the patient had been medicated with a narcotic,had urinary urgency so had not taken the time to put on shoes,failed to turn on the light because the door to the hall let in some light,and stumbled over a towel that had been placed to collect water leaks caused by construction that was in progress to replace damaged sinks.Which factor was a special cause variation?

Accepted Answer

Special cause variation refers to an unusual, non-random event that is not part of the system's normal operation. The construction causing leaks and the need for a towel to collect water is an external factor, not part of the regular hospital environment or patient care process, making it a special cause variation.

Question 19

Which of the following occurrences would be classified as a sentinel event?

Accepted Answer

A sentinel event is defined as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. The incorrect identification and subsequent surgery on the wrong twin (Choice C) directly fits this definition, as it involves a serious risk to the patient's safety and well-being.

Question 20

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance.Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits.This pictorial representation is documented using what tool?

Accepted Answer

A control chart is used to monitor the variation and stability of a process over time, which aligns with tracking compliance with the standard for patient assessments by RNs within a specific timeframe.

Quiz 22: Quality Improvement and Patient Safety

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures.The focus of this team is primarily on which Institute of Medicine (IOM) competency?